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What are the components of a CBC Complete Blood Count
- Hb
- Hct
- RBC/Indices
- WBC
- Platelets
- Blood Smear Eval.
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A Hb count is a good indicator for
- Oxygen carrying capacity
- Diagnosis for anemia (prefered over
- Hct)
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What is polycythemia
Above average RBC count
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What is the most important blood test for classifying anemia
Mean corpuscular volume MCV
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Mean corpuscular volume ranges are
- Microcytic <80
- Macrocytic >100
- Normocytic 80-100
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Red cell distribution width (RDW) detects for
Anisocytosis
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Leukopenia differs from luekocytosis how
- Penia is a low white blood count
- Cytosis is a high count
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What is TLC
Total Luekocyte count
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What is a DLC
Differential leukocyte count, compares different white blood cell numbers
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A microcytic RBC has what distinguishing traits
They have a central palor larger than normal
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What is a normalblast cell
It is a erythrocyte that contains a nucleus and should be located in the bone marrow
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Why would you see a normoblast in the blood stream
It could be a result of massive hemorrhaging or hemolysis
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What are the newly released RBC's from the bone marrow, and how are they identified
Reticulocytes, they have ribosomal filaments in the cytoplasm
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Why would the reticulocyte count be important
To determine if the marrow is effective at erythropoeisis (<3% is normal)
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The Reticulocyte count is falsley elevated when
When there is anemia, the body is trying to compensate
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What is the ESR and what is it used for
Erythrocyte sedimentation rate, it is a non-specific indicator of tissue injury, inflammation, and cancer
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Hyperchromic is
An elevated amount of Hb concentration and a loss of central pallor
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Polychromasia can be described as
RBC's with more than one color, presence of RNA, and increase amount of reticulocytes
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What is poikilocytosis
A variation in the shape of RBC's
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What are the different shapes that can be seen in an abnormal RBC
- Microspherocyte
- Sickle cell
- Tear drop
- Schistocyte
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What are the causes of the abnormal RBC shapes
- Microspherocyte - hereditary, immune hemolytic anemia
- Sickle cell - Homozygous sickle cell disease
- Tear drop - Marrow infiltration (myelofibrosis)
- Schistocyte - Microangiopathic haemolytic anaemia
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What could be the cause of hyperchromic RBC's
- Hereditary spherocytosis
- Autoimmune hemolytic anemia
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A sickle cell can also be called
Drepanocyte
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Schistocytes can be caused by
Hemolytic anemia
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A tear drop cell can also be called
Dacrocyte
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What conditions can cause a target cell to have its appearance
- Thalassemia
- Iron deficiency anemia
- Alcoholic liver disease
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What is a punctate basophilia and what could cause it
Altered reticulocyte with basophilic spotting that has the desire to aggregate with one another, it is caused by Lead poisoning mostly, drug exposure, alcoholism
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What is the appearance of a Howell Jolly body, and what is it caused by
- It has a purple dot like an eye ball
- These can occur when there is absence of a spleen, or a non functioning spleen.
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What is the appearence of a Heinz body, and what can cause it
- It has particle of denatured hemoglobin just on the inside of the membrane
- Caused by G6PD deficiency (Oxidation injury)
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Siderocytes are
RBC's with a couple iron granules, are caused by an iron overload.
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What are the three broad groups that you can classify anemia into (Etiologicaly)
- Increased Blood loss
- Impaired RBC production
- Increased RBC destruction
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What are some of the causes of RBC loss
- Trauma
- Lesions in the GI tract
- Urinary tract loss
- Gynecological effects
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Why in chronic disease do you sometimes see anemia
The iron is not transferred form the ferritin in attempt to hide it from bacteria
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What is metastatic neoplasm
When a disease has spread to other organs via metastasis
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Parvovirus B19 infection does what
Infects and destroys red blood cell progenitors
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What are the primary tests used to classify anemia
- Mean corpuscular volume
- Reticulocyte count
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Microcytic anemia is caused by what different conditions
- Iron deficiency
- Thalassemia
- Sideroblastic anemia (lead poisoning)
- Anemia of chronic disease
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What are some of the causes of macrocytic anemia
- Folate/B12 deficiency
- Alcoholism
- Drugs
- Myelodysplastic syndrome (ineffective myeloid production)
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What are the classic symptoms and signs of a patient with anemia
- Fatigue
- Breathlessness
- Tachycardia
- Systolic murmur
- Paleness
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What is the difference between hemolytic anemia and non-hemolytic anemia
Hemolytic has a reticulocyte count above 3%
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If a patient has an onset of anemia due to an iron deficiency what are some symptoms specifically caused by this
- Spooned shaped nails (Koilonychia)
- Fissures at the angle of the mouth (Cheilosis)
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B12 deficiency often manifests itself physically through
- Tingling and numbness in hands and feet
- Unsteady Gait
- Impaired senses
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Hemolytic anemia is physically manifest often as
- Jaundice
- Hepatosplenomegaly
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What would be the lab results in a megaloblastic anemia
- Low Hb
- Excessive macrocytes
- Normal/Decreased Reticulocyte count
- Hypersegmented neutrophils
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Fanconi anemia
Inherited disease with stem cell depletion decreasing the bone marrow function
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Granulomatous neoplasm
Mass of immune cells dealing with metastatic neoplasm
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Pernicious anemia exhibits what lab findings and cell type
There will be a larger MCV, megaloblastic cells, and hyper segmentation of Neutrophils
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What are some causes of Leukocytosis
- Chronic infections
- Myeloproliferative disorders
- Chronic Inflammation
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What effect do glucocorticoids have on the presence of Leukocytes in the blood
They turn down inflammation keeping them in the blood instead of the tissues
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What are catecholamines and what are their effects on Leukocytes in the blood
They are the fight or flight hormones and along with exercise cause and increase in the blood
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How can septic shock and hypoxia effect the leukocyte count in the blood
It will increase them
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A large increase in a bacteria infection will effect what cells in the blood stream
Neutrophils
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How do corticosteroids effect neutrophils in the blood
They cause inflammation to go down, therefore the neutrophils won't be as apt to entering the tissue or leaving the bone marrow.
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What are Dohle bodies in neutrophils
These are dull gray patches of dilated Rough ER
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Toxic granules, Dohle bodies, and Cytoplasmic vacuoles in neutrophils can be and indication of what
Sepsis or severe inflammation disorders
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What conditions would cause an increase in the amount of Eosinophils in the blood stream
- Allergic reactions
- Parasitic infections
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A raise in the amount of basophils in the blood is rare but could indicate
Chronic myeloid leukemia (increase in the growth of myeloid cells)
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Monocytosis is a marker for chronic inflammation and infections and can be caused by what specific conditions
- Bacterial endocarditis
- UC
- Lupus
- Tuberculosis
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What are some of the classic causes of Lymphocytosis
- Mono
- Mumps
- Measles
- TB
- Whooping cough
- Graves disease
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What are some clinical findings in Mono
Classic triad, Fever, sore throat, Gray and white membrane on tonsils
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Why is a lymphocytosis condition called mononucleosis
Because in a blood smear the lymphocytes look similar to monocytes
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What effects does Infectious Mononucleosis (IM) have on the lymph nodes
It increases the size of the paracortex due to the large T cell proliferation
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Why must patients with Mono avoid contact sports till they are better
They could rupture their enlarged spleen killing them
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What is para-cortical hyperplasia
It is the abnormal T cell proliferation specifically in the paracortex of the lymph nodes
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What can cause para-cortical hyperplasia
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What are the clinical signs for Neutropenia
- Malaise
- Chills
- Fever
- Fatigue
- Large lymph nodes
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What are clinical signs for Agranulocytosis
- Mouth ulcers with psuedo membranes laden with infective bacteria or fungi
- Death with in a few days
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Pancytopenia means
There is a decrease in the amount of RBC, WBC and platelets found in the blood because they are being inappropriately phagocytosed
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What does a serum homocystein test screen for
Folic acid and B12
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What is a leukemoid reaction
High leukocyte count with immature myeloid granulocytes
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What could cause a leukemoid reaction
- Severe infections- Sepsis
- Appendicitis
- Whooping cough
- Mononucleosis
- Severe hemorrhaging
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